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Maine rates for HCPCS 95977

Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with complex cranial nerve neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.40 / $55.40 / $56.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.08 / $56.15 / $77.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.85 / $65.20 / $90.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.74 / $81.77 / $120.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.90 / $64.48 / $110.47
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.47 / $56.24 / $78.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.96 / $76.23 / $104.00